Legislative Advocacy:

Successful advocacy requires a professional, 24/7 team making working to ensure success, all while protecting our profession from harmful legislation.  Recent examples of MSNJ’s hard work include:

      Enactment of the ASC “Right to Referral Bill,” which allows patients to have procedures done at ambulatory facilities partly owned by the referring physician an preserves the licensure exemption for single-room surgical practices.

      Fixing the Patient Safety “No-Pay” Bill, which almost prohibited physicians from billing for care needed to correct systemic errors;

      Improving the Involuntary Outpatient Commitment Bill, by strengthening the role of physicians in placing patients in need of mental health treatment;

      Passing the 30 X 3 Rx Bill, which allows physicians to issue multiple, post-dated prescriptions to patients that have demonstrated stability on certain drug regimens; and

      Passing the Assignment of Benefits bill late last session.  This legislation, which goes into effect next January, will ensure that patients’ wished are followed when they instruct their insurance to send payment directly to out-of-network physicians.

With the last legislative session behind us, we are already hard at work on legislation pending this year.  By far, the highest profile bills are related to efforts by both physicians and insurers to change how out-of-network care is provided and paid for.  This debate has the potential for both positive and negative developments, and includes legislation such as:

v     The “Ingenix-Fix” bill, which would create a home-grown replacement for the flawed Ingenix charges profile that better reflects usual and customary charges.  MSNJ supports this legislation.

v     Balanced Billing legislation, which would make it a crime to waive a patient’s out-of-pocket expenses.  MSNJ opposes this attack on the physician/patient relationship.

v     Referral Disclosure legislation, which would unfairly make referring physicians responsible for determining other providers’ network status. MSNJ opposes this additional administrative burden.

Legal Advocacy:

When successful advocacy seems too elusive in the legislative and executive branches of government, our eyes turn to the MSNJ legal team which is engaged in numerous actions including:

      Ryan v Renny, where MSNJ is taking on attempts by personal injury attorneys to decimate the affidavit of merit lawsuit protections; and

      Betencourt v Trinitas, where MSNJ is supporting several physicians who are being compelled by the courts to provide futile care against their ethical principles.

MSNJ also prevailed in a number of class-action suits designed to require fairer business practices by insurers earlier this decade, and assists its members in compelling compliance with the terms of those settlements.